A new concern over the spread of Ebola surfaced recently when a Dallas County sheriff's deputy who searched the apartment of the first patient to die from the virus in the U.S. started feeling ill and went to an urgent-care center.
The clinics popping up rapidly across the nation aren't designed to treat serious illnesses and are ill-equipped to deal with suspected Ebola cases.
Doctors are urging patients to avoid smaller medical facilities and head to emergency rooms if they think they've been exposed to the virus that has put a focus on weak spots in the U.S. health care system.
"Patients have a difficult time deciding where they need to go for care" but hospitals are best for serious problems, Dr. William Gluckman said.
The Dallas County deputy was transferred to a hospital this month where he tested negative for Ebola. Clinics, meanwhile, have rushed to prepare with new training manuals and protective gear. But most lack essentials like isolation units, said Gluckman of the Urgent Care Association of America, which represents more than 2,600 of the nation's 9,000 urgent-care centers.
Given the problems at the Dallas hospital where Thomas Eric Duncan died and two nurses were diagnosed with the virus, experts say an Ebola case at a clinic or smaller facility could have been worse.
"That would be an even less controlled situation," said Dr. David Weber, a disease specialist with the University of North Carolina. "The likelihood for that is so remote that they may never have thought about that."
That's changed recently as the Urgent Care Association of America sent emails to its roughly 6,400 members asking them to send suspected Ebola cases to hospitals for treatment.
If someone has a fever, headache or other flu-like symptoms and has been in an Ebola hot spot, clinics have been told to contain that patient in a single room, call public health officials and contact a hospital for transportation as quickly as possible, per Centers for Disease Control and Prevention guidelines.
The CDC says Ebola isn't contagious until symptoms appear and isn't spread through the air; people catch it by direct contact with a sick person's bodily fluids, such as blood or vomit.
CDC Director Tom Frieden said last week that the agency is bolstering training nationwide on how to respond to an Ebola case, a pledge that came days after a man who had been to West Africa and was suffering from flu-like symptoms briefly shut down an urgent care practice near Boston. He was taken to a hospital where he tested negative for Ebola.
As U.S. health care has become more complex — with retail clinics, urgent-care centers, work-site clinics and even online clinics — it's also become a challenge to ensure that everyone strictly follows protocol. But that's not necessarily a bad thing, said Dr. Tom Zweng of Novant Health, an urgent-care system based in North Carolina.
"This is not an exercise in futility," he said. "This is preparing staff in safe practices. It may be Ebola today, but tomorrow there may be another communicable disease that we don't even know about. This is about taking health care in this country to the next level."